Percutaneous ultrasound‐guided sclerotherapy for complicated fetal intralobar bronchopulmonary sequestration

Bermúdez, Carlos; Pérez-Wulff, Juan; Bufalino, Gesualdo; Sosa, Cristian; Gómez, Libardo; Quintero, Rubén A.

doi:10.1002/uog.3944

Cited by 45 publications

(36 citation statements)

References 28 publications

(37 reference statements)

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“…Prenatal tedavide fetal furosemid ve digoksin tedavisi, USG eşliğinde perkütanöz fetal skleroterapi (alkol veya 1 mL %3 polidocanol ile) [6], torako-amniotik şant, ekstralober olanlarda açık fetal cerrahi veya 3. trimestrde spontan regresyon olabilmesi nedeniyle gözlem uygulanabilir [4]. Postnatal tedavide ise cerrahi veya aberran sistemik arterin embolizasyonu uygulanır.…”

Section: Discussionunclassified

Intralobar Pulmonary Sequestration: A Case Report

Şanlı¹,

Işık²,

Arslan³

et al. 2012

Tur Toraks Der

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Pulmonary sequestration is an embryonic, and radyological and histopathological cystic lung tissue that is nonfunctional with systemic arterial vascularization and unconnected to normal tracheaobronchial system. Early surgical intervention should be performed in order to protect lung parenchyma and to prevent possible complications and infections in pulmonary sequestration cases. Attentive preoperative imaging study and planning should be done. We present an uncommon case with typical intralobar pulmonary sequestration located in the left lower lobe. ( Ekstralober (ELS) ve intralobar sekestrasyon (İLS) olarak iki tipte bulunur. Nadiren ikisi birlikte olabilir. Sekestrasyonun her iki tipinde de arteryel destek sistemiktir, fakat venöz drenaj tipe göre değişir. Arter, genellikle torasik veya abdominal aortadan (diafragmayı penetre eder) doğar. Olguların %20'sinde multipl arteryel beslenme söz konusudur.Kliniğimizde sol alt lobda yerleşim gösteren intralober sekestrasyon olgusunu, lezyonun nadir görülmesi ve radyolojik/operatif tipik görüntü nedeniyle sekestrasyona ait literatür bilgilerini hatırlatarak sunduk. OLGUKırk iki yaşındaki erkek olgu, sırt ağrısı, nefes darlığı, terleme yakınmaları nedeniyle hastanemiz Göğüs Hastalıkları kliniğince yatırıldı. Altı aydır 1 paket/gün sigara içme öyküsü mevcuttu. Yakınmaları 2 yıldır mevcut olan ve öyküde çocukluk yıllarına ait bir sorun tanımlama-yan olgu, 5 yıl önce geçirmiş olduğu pnömoniyi tanımla-dı. Fizik muayenede sol akciğer bazalinde ronflan ralleri dışında patolojik bulgu saptanmadı. Laboratuvar incelemelerinde anormallik yoktu. Solunum fonksiyon testlerinde FVC 3.71 lt (%100), FEV 1 3.06 lt (%98) ve FEV 1 /FVC 82 olarak saptandı. Arteryel kan gazları analizinde (oda havasında) pO 2 : 99.0 mmHg, pCO 2 : 39.8 mmHg, pH: 7.34 ve SO 2 : %96.9 idi.Göğüs radyografisinde alt lob medialde kistik görüntü-lerin eşlik ettiği konsolide saha görünümü vardı. Toraksın spiral bilgisayarlı tomografisinde (BT) (Brilliance 6, Philips Medical Systems, Cleveland, Ohio), sol akciğer alt lob paravertebral alan komşuluğunda yerleşen, komşu parankim alanlarında yer yer konsolidasyon alanları ve nodüler 38

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Section: Discussionunclassified

Intralobar Pulmonary Sequestration: A Case Report

Şanlı¹,

Işık²,

Arslan³

et al. 2012

Tur Toraks Der

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“…It carries additional maternal surgical risks and creates a uterine scar. Doppler ultrasound guided fetoscopic laser vessel ablation is a minimally invasive alternative, with survival rates in excess of 87.5% [101,103]; sclerosants injected into the aberrant vessel have shown high success rates, but trials have small numbers [104,105]. Complication rates are not quoted.…”

Section: Bronchopulmonary Sequestrationmentioning

confidence: 99%

Pathophysiological mechanisms of high-intensity focused ultrasound-mediated vascular occlusion and relevance to non-invasive fetal surgery

Shaw

Haar

Rivens

et al. 2014

J. R. Soc. Interface.

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ReviewCite this article: Shaw CJ, ter Haar GR, Rivens IH, Giussani DA, Lees CC. 2014 Pathophysiological mechanisms of high-intensity focused ultrasound-mediated vascular occlusion and relevance to non-invasive fetal surgery. J. R. Soc. High-intensity focused ultrasound (HIFU) is a non-invasive technology, which can be used occlude blood vessels in the body. Both the theory underlying and practical process of blood vessel occlusion are still under development and relatively sparse in vivo experimental and therapeutic data exist. HIFU would however provide an alternative to surgery, particularly in circumstances where serious complications inherent to surgery outweigh the potential benefits. Accordingly, the HIFU technique would be of particular utility for fetal and placental interventions, where open or endoscopic surgery is fraught with difficulty and likelihood of complications including premature delivery. This assumes that HIFU could be shown to safely and effectively occlude blood vessels in utero. To understand these mechanisms more fully, we present a review of relevant cross-specialty literature on the topic of vascular HIFU and suggest an integrative mechanism taking into account clinical, physical and engineering considerations through which HIFU may produce vascular occlusion. This model may aid in the design of HIFU protocols to further develop this area, and might be adapted to provide a non-invasive therapy for conditions in fetal medicine where vascular occlusion is beneficial.

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“…que otros realizan técnicas percutáneas como ablación láser 49 o con drogas esclerosantes como el polidocanol 53 o el N-butil 2-cianoacrilato 49 del vaso nutricio en caso de secuestro pulmonar, o polidocanol en la lesión para MAQ. 54 En las lesiones macroquísticas las opciones terapéuticas incluyen la toracocentesis con aguja fina para drenar el líquido y reducir el tamaño de la masa, o la colocación de un catéter de derivación tóraco-amniótico.…”

Section: Figura 6 Ejemplo De Malformación Adenomatoidea Quística (Maunclassified

Avances en terapia fetal

2013

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Avances en terapia fetal Advances in fetal therapy RESUMENEn ciertas ocasiones puede ser necesario realizar una intervención prenatal con el objetivo de salvar la vida fetal o prevenir un daño permanente. Estas intervenciones terapéuticas prenatales pueden ser clasificadas en farmacológicas o invasivas. Las primeras están caracterizadas por la administración de medicamentos a la madre que atraviesan la placenta y ejercen una acción terapéutica sobre el feto. Las invasivas incluyen intervenciones percutáneas con aguja fina, fetoscopías y cirugías a cielo abierto. Nos referiremos en este trabajo a las principales intervenciones prenatales que se realizan en la actualidad. Palabras clave: terapia fetal, cirugía fetal, investigación fetal, procedimientos invasivos. SUMMARYFetal therapy may be needed in certain clinical settings with the primary indication to improve perinatal or long-term outcomes for the fetus or the newborn. It can be classified in pharmacotherapy or non-invasive, and invasive therapy. The first one involves the administration of drugs to the mother that cross the placenta and get to the fetus, a non-invasive approach. On the other hand, invasive therapy involves the use of needles, fetoscopic treatments or open fetal surgery. This review provides an update of non-invasive and invasive fetal therapy.

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Percutaneous ultrasound‐guided sclerotherapy for complicated fetal intralobar bronchopulmonary sequestration

Abstract: Bronchopulmonary sequestration (BPS),

Cited by 45 publications

References 28 publications

Intralobar Pulmonary Sequestration: A Case Report

Intralobar Pulmonary Sequestration: A Case Report

Pathophysiological mechanisms of high-intensity focused ultrasound-mediated vascular occlusion and relevance to non-invasive fetal surgery

Avances en terapia fetal

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